Seid M, Varni J W, Bermudez L O, Zivkovic M, Far M D, Nelson M, Kurtin P S
Center for Child Health Outcomes, Children's Hospital and Health Center, San Diego, California, USA.
Pediatrics. 2001 Aug;108(2):264-70. doi: 10.1542/peds.108.2.264.
A measure of pediatric primary care quality that is brief, practical, reliable, and valid would be useful to patients and pediatricians, policymakers, and health system leaders. Parents have a unique perspective from which to report their experiences with their child's primary care, and these reports may be valid indicators of pediatric primary care quality. The research objective was to develop a brief parent report of their children's primary care, the Parent's Perceptions of Primary Care measure (P3C), and to test its reliability and validity as a measure of pediatric primary care quality.
The P3C was based on the elements of primary care as defined by the Institute of Medicine. Pretesting of domain content and item clarity was accomplished via focus interviews. The P3C was developed in English and translated to Spanish, Vietnamese, and Tagalog. The 23-item P3C yields a total score, as well as subscale scores for continuity, access, contextual knowledge, communication, comprehensiveness, and coordination. The P3C was administered to 3371 parents of children in kindergarten through sixth grades in a large, urban school district.
The percentage of missing values for the overall sample was 1.88%, indicating acceptable feasibility. Range of measurement, assessed via floor and ceiling effects, was moderate to good. Cronbach's coefficient alpha, an indicator of scale internal consistency reliability, was 0.95 for the P3C total scale. Factor analysis supported the subscale structure, and P3C scores were higher for children with health insurance, whose parents completed the survey in English, and who had a regular physician. P3C scores were positively related to parent reports of the child's health-related quality of life.
The P3C is a practical, reliable, and valid measure of parents' reports of pediatric primary care quality. This brief measure could be used alone, or in conjunction with other measures, to enhance outcomes and evaluate the impact of systems changes on the delivery of the main elements of primary care.
一种简短、实用、可靠且有效的儿科初级保健质量衡量指标，对患者、儿科医生、政策制定者和卫生系统领导者都将有所帮助。父母对于报告孩子初级保健经历有着独特的视角，这些报告可能是儿科初级保健质量的有效指标。本研究的目的是开发一份简短的父母对孩子初级保健的报告，即“父母对初级保健的认知量表（P3C）”，并测试其作为儿科初级保健质量衡量指标的可靠性和有效性。
P3C基于医学研究所定义的初级保健要素。通过焦点访谈完成对领域内容和项目清晰度的预测试。P3C最初以英文开发，并被翻译成西班牙语、越南语和他加禄语。包含23个条目的P3C可得出总分，以及连续性、可及性、背景知识、沟通、全面性和协调性等子量表分数。P3C被施测于一个大型城市学区中幼儿园至六年级孩子的3371名家长。
总体样本的缺失值百分比为1.88%，表明可行性可接受。通过地板效应和天花板效应评估的测量范围为中等至良好。作为量表内部一致性可靠性指标的克朗巴哈系数α，P3C总量表为0.95。因子分析支持子量表结构，并且对于有健康保险、其父母用英语完成调查以及有固定医生的孩子，P3C得分更高。P3C得分与父母报告的孩子健康相关生活质量呈正相关。
P3C是父母对儿科初级保健质量报告的一种实用、可靠且有效的衡量指标。这种简短的衡量指标可单独使用，或与其他指标结合使用，以改善结果并评估系统变化对初级保健主要要素提供的影响。
